K Number
K183537
Device Name
PANAVIA SA Cement Universal
Date Cleared
2019-04-25

(127 days)

Product Code
Regulation Number
872.3275
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
[1] Cementation of crowns, bridges, inlays and onlays [2] Cementation of prosthetic restorations on implant abutments and frames [3] Cementation of adhesion bridges and splints [4] Cementation of posts and cores [5] Amalgam bonding
Device Description
PANAVIA SA Cement Universal is a dual-cure (light- and/or self-cure), fluoride releasing, radiopaque self-adhesive resin cement for ceramic (porcelain, lithium disilicate, zirconia, etc.), composite resin, and metal restorations. It has a choice of Automix delivery (equal amounts of two components are combined through a mixing tip) or Handmix (equal amount of two components are combined on a mixing pad).
More Information

No
The device description and performance studies focus on the physical and chemical properties of a dental cement, with no mention of AI or ML technologies.

No.
This device is a dental cement used for the cementation of various dental restorations, not for treating diseases or conditions.

No

Explanation: The device is a dental cement used for bonding and securing restorations, not for diagnosing medical conditions. Its intended use is for "Cementation of crowns, bridges, inlays and onlays," among other restorative procedures.

No

The device description clearly indicates it is a physical resin cement product, not software.

No, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended uses listed are all related to the cementation of dental restorations and prosthetics within the patient's mouth. This is a direct clinical application, not a test performed on a sample taken from the body.
  • Device Description: The description details a dental cement used for bonding materials to teeth and other dental structures. It doesn't describe a device that analyzes biological samples.
  • Lack of IVD Characteristics: The document does not mention any of the typical characteristics of an IVD, such as:
    • Analyzing biological samples (blood, urine, tissue, etc.)
    • Providing diagnostic information about a patient's health condition
    • Using reagents or assays to detect specific substances

The device is a dental material used for restorative procedures, which falls under the category of medical devices, but not specifically In Vitro Diagnostics.

N/A

Intended Use / Indications for Use

PANAVIA SA Cement Universal is indicated for the following uses:
[1] Cementation of crowns, bridges, inlays and onlays
[2] Cementation of prosthetic restorations on implant abutments and frames
[3] Cementation of adhesion bridges and splints
[4] Cementation of posts and cores
[5] Amalgam bonding

Product codes

EMA, KLE

Device Description

PANAVIA SA Cement Universal is a dual-cure (light- and/or self-cure), fluoride releasing, radiopaque self-adhesive resin cement for ceramic (porcelain, lithium disilicate, zirconia, etc.), composite resin, and metal restorations. It has a choice of Automix delivery (equal amounts of two components are combined through a mixing tip) or Handmix (equal amount of two components are combined on a mixing pad). This is the new registration application for the subject device and there have not been any prior submissions regarding the subject device.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

Not Found

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

Physical and mechanical properties of the subject device were evaluated according to ISO 4049: 2009 (Dentistry - Polymer-based restorative and materials).
The results of comparative study performed according to ISO 4049: 2009 for film thickness, working time, setting time, flexural strength, water sorption and solubility, color stability after irradiation and water sorption, and radio-opacity indicate that the subject device and the predicate device comply with the requirements.
The bond strengths to all substrates (Tooth dentin, Tooth enamel, Ceramic, Metal, Titan, Composite resin, Amalgam) of the subject device were not statistically (P>0.05) different from that of the predicate device.
Released fluorine ion test was performed and it was concluded that the amount of released fluorine ion from the subject device is substantially equivalent to that of the predicate device.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Not Found

Predicate Device(s)

K142625

Reference Device(s)

K130371, K142623

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

§ 872.3275 Dental cement.

(a)
Zinc oxide-eugenol —(1)Identification. Zinc oxide-eugenol is a device composed of zinc oxide-eugenol intended to serve as a temporary tooth filling or as a base cement to affix a temporary tooth filling, to affix dental devices such as crowns or bridges, or to be applied to a tooth to protect the tooth pulp.(2)
Classification. Class I (general controls). The device is exempt from the premarket notification procedures in subpart E of part 807 of this chapter subject to § 872.9.(b)
Dental cement other than zinc oxide-eugenol —(1)Identification. Dental cement other than zinc oxide-eugenol is a device composed of various materials other than zinc oxide-eugenol intended to serve as a temporary tooth filling or as a base cement to affix a temporary tooth filling, to affix dental devices such as crowns or bridges, or to be applied to a tooth to protect the tooth pulp.(2)
Classification. Class II.

0

Image /page/0/Picture/0 description: The image shows the logos of the Department of Health and Human Services and the Food and Drug Administration (FDA). The Department of Health and Human Services logo is on the left, and the FDA logo is on the right. The FDA logo is a blue square with the letters "FDA" in white, followed by the words "U.S. Food & Drug Administration" in blue.

April 25, 2019

Kuraray Noritake Dental Inc. Yasuiiro Ohara Manager Ote Center Bldg. 7F, 1-1-3, Otemachi Chiyoda-ku, Tokyo 100-0004 JAPAN

Re: K183537

Trade/Device Name: PANAVIA SA Cement Universal Regulation Number: 21 CFR 872.3275 Regulation Name: Dental Cement Regulatory Class: Class II Product Code: EMA, KLE Dated: January 24, 2019 Received: January 28, 2019

Dear Yasujiro Ohara:

We have reviewed vour Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal

1

statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/CombinationProducts/GuidanceRegulatoryInformation/ucm597488.html; good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4, Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Srinivas Nandkumar -S

for Tina Kiang, Ph.D. Acting Director Division of Anesthesiology, General Hospital, Respiratory, Infection Control, and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

2

Indications for Use

510(k) Number (if known): K183537

Device Name: PANAVIA SA Cement Universal

Indications for Use:

PANAVIA SA Cement Universal is indicated for the following uses:

[1] Cementation of crowns, bridges, inlays and onlays

[2] Cementation of prosthetic restorations on implant abutments and frames

[3] Cementation of adhesion bridges and splints

[4] Cementation of posts and cores

[5] Amalgam bonding

Prescription Use (Part 21 CFR 801 Subpart D)

AND/OR

Over-The-Counter Use (21 CFR 801 Subpart C)

(PLEASE DO NOT WRITE BELOW THIS LINE-CONTINUE ON ANOTHER PAGE IF NEEDED)

Concurrence of CDRH, Office of Device Evaluation (ODE)

3

January 24th, 2019 Date:

K183537

510(k) Summary

3-1. 510(k) owner (submitter)

1) NameKuraray Noritake Dental Inc.
2) Address1621 Sakazu, Kurashiki, Okayama 710-0801, Japan
3) Contact personYasujiro Ohara
Quality Assurance Department
4) Contact person in USManabu Suzuki
KURARAY AMERICA, INC.
33 Maiden Lane, 6th Floor, New York, NY 10038
Tel: (212)-986-2230 (Ext. 115) or (800)-879-1676
Fax: (212)-867-3543
3-2. Name of Device
1) Trade / Proprietary namePANAVIA SA Cement Universal
2) Classification nameDental cement
(21 CFR section 872.3275. Product code: EMA)
3) Common nameDental adhesive resin cement
3-3. Predicate device
1)PANAVIA SA Cement Plus Automix510(k) Number
Classification:
Product Code:
21 CFR Section:
Applicant:K142625
Dental cement
EMA
872.3275
Kuraray Noritake Dental Inc.
3-4. Reference devices
1)CLEARFIL MAJESTY ES Flow510(k) Number:
Classification:
Product Code:
21 CFR Section:
Applicant:K130371
Tooth shade resin material
EBF
872.3690
Kuraray Noritake Dental Inc.
2)PANAVIA SA Cement Plus Handmix510(k) Number:
Classification:
Product Code:
21 CFR Section:
Applicant:K142623
Dental cement
EMA
872.3275
Kuraray Noritake Dental Inc.

3-5. Device Description

PANAVIA SA Cement Universal is a dual-cure (light- and/or self-cure), fluoride releasing, radiopaque self-adhesive resin cement for ceramic (porcelain, lithium disilicate, zirconia, etc.), composite resin, and metal restorations. It has a choice of Automix delivery (equal amounts of two components are combined through a mixing tip) or Handmix (equal amount of two components are combined on a mixing pad). This is the new registration application for the subject device and there have not been any prior submissions regarding the subject device.

4

3-6. Statement of Intended Use

PANAVIA SA Cement Universal is indicated for the following uses:

[1] Cementation of crowns, bridges, inlays and onlays

  • [2] Cementation of prosthetic restorations on implant abutments and frames
  • [3] Cementation of adhesion bridges and splints
  • [4] Cementation of posts and cores
  • [5] Amalgam bonding

3-7. Substantial Equivalence Discussion

1) Intended uses

Intended uses of the subject device and predicate devices, PANAVIA SA Cement Plus Automix which is self-adhesive resin cement which is dental resin cement, is as listed on the following table.

Trade nameIntended use
Subject
devicePANAVIA SA
Cement Universal[1] Cementation of crowns, bridges, inlays and onlays
[2] Cementation of prosthetic restorations on implant abutments
and frames
Predicate
devicePANAVIA SA
Cement Plus Automix[3] Cementation of adhesion bridges and splints
[4] Cementation of posts and cores
[5] Amalgam bonding

The intended use of the subject device is the same as that of the predicate device. Therefore, the intended use of the subject device is substantially equivalent to that of the predicate device.

2) Chemical ingredients/ Safety

All ingredients in the subject device have been used in the predicate device and reference devices. Regarding the predicate device and reference devices, there have not been any reported problems or recalls according to the post market adverse event reporting requirements in the US. From the above, it was concluded that the subject device is substantially equivalent in biological safety to the predicate device and reference devices.

  1. Technological characteristics/ Effectiveness and Performance

Physical and mechanical properties of the subject device were evaluated according to ISO 4049: 2009 (Dentistry - Polymer-based restorative and materials).

5

The results of comparative study performed according to ISO 4049: 2009 were indicated below.

| Section | PANAVIA SA Cement Universal (Handmix)
(Subject device) | | PANAVIA SA Cement Plus Automix
(Predicate device) | | |
|----------------------------------------------------------|-----------------------------------------------------------|----------------------|------------------------------------------------------|----------------------|----------|
| | Shade type:
Universal (A2) | Shade type:
White | Shade type:
Universal (A2) | Shade type:
White | |
| | 5.2.2 Film thickness, luting materials | COMPLIES | COMPLIES | COMPLIES | COMPLIES |
| 5.2.4 Working time, Class 1 and Class 3 luting materials | COMPLIES | COMPLIES | COMPLIES | COMPLIES | |
| 5.2.6 Setting time, Class 3 materials | COMPLIES | COMPLIES | COMPLIES | COMPLIES | |
| 5.2.9 Flexural strength | COMPLIES | COMPLIES | COMPLIES | COMPLIES | |
| 5.2.10 Water sorption and solubility | Water sorption | COMPLIES | COMPLIES | COMPLIES | COMPLIES |
| | Solubility | COMPLIES | COMPLIES | COMPLIES | COMPLIES |
| 5.4 Color stability after irradiation and water sorption | COMPLIES | COMPLIES | COMPLIES | COMPLIES | |
| 5.5 Radio-opacity | COMPLIES | COMPLIES | COMPLIES | COMPLIES | |

The results indicate that the subject device and the predicate device comply with the requirements of ISO 4049: 2009. From the above, it can be said that comparative study of the subject device is substantially equivalent to that of the predicate device.

6

| Adherend surface
(Material composition) | Criteria | Subject device
(Handmix) | | Predicate device |
|--------------------------------------------|----------------------|-----------------------------|----------|-----------------------------------|
| Tooth dentin | In-house
standard | COMPLIES | COMPLIES | |
| Tooth enamel | | COMPLIES | COMPLIES | |
| Ceramic | | COMPLIES | COMPLIES | |
| Metal | | COMPLIES | COMPLIES | PANAVIA SA Cement
Plus Automix |
| Titan | | COMPLIES | COMPLIES | |
| Composite resin | | COMPLIES | COMPLIES | |
| Amalgam | | COMPLIES | COMPLIES | |

The result of Bond strength test

The bond strengths to all substrates of the subject device were not statistically (P>0.05) different from that of the predicate device.

Therefore, it was concluded that the bonding performance to all substrates of the subject device was equivalent to that of the predicate device.

Released fluorine ion test was performed to validate the substantial equivalence of the subject device with the predicate device.

It was concluded that amount of released fluorine ion from the subject device is substantially equivalent to that of the predicate device.

3-8. Biocompatibility

The subject device is classified according to ISO 7405:2008 and ISO 10993-1:2009 as an external communicating device that will have permanent (> 30 days) contact with tissues.

All ingredients in the subject device have been used in the predicate device and the reference devices as listed on the "Table 7-5-1.and 7-5-2." in "Section 7: Substantial Equivalence Discussion". And those devices are also classified as an external communicating device that will have permanent (> 30 days) contact with tissues.

Regarding the predicate device and the reference devices, there have not been any reported problems or recalls according to the post market adverse event reporting requirements in the US.

Concerning the track records of the ingredients, intended use, manufacturing process, contact part and contact duration, all of them are substantially equivalent to those of the predicate device and the reference devices.

These facts lead us to conclude that the subject device is substantially equivalent in biocompatibility to the predicate device and the reference devices without performing additional biological tests.

3-9. Conclusion

The comparison for intended uses, chemical ingredients/ safety and performance data shows that the subject device is substantially equivalent to the predicate device and the reference devices. This submission information including the nonclinical testing provided supports that the subject device is as safe and as effective as the predicate device and the reference devices.